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体重指数对肥厚型梗阻性心肌病(HOCM)患者左心房内径的影响。

Impact of body mass index on left atrial dimension in HOCM patients.

作者信息

Zhou Yue, Yu Miao, Cui Jingang, Liu Shengwen, Yuan Jiansong, Qiao Shubin

机构信息

Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, Beijing 100037, China.

Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China.

出版信息

Open Med (Wars). 2021 Jan 27;16(1):207-216. doi: 10.1515/med-2021-0224. eCollection 2021.

Abstract

BACKGROUND

Substantial studies have demonstrated that left atrial (LA) enlargement was a robust predictor of atrial fibrillation (AF) and obesity was a modifiable risk factor for cardiovascular diseases. However, the role of body mass index (BMI) on LA dimension in hypertrophic obstructive cardiomyopathy (HOCM) remains unclear.

METHODS

A total of 423 HOCM patients (average BMI 25.4 ± 3.4 kg/m) were recruited for our study. Participants were stratified into three groups based on BMI: normal weight (BMI < 23 kg/m), overweight (BMI 23-27.5 kg/m), and obesity (BMI ≥ 27.5 kg/m).

RESULTS

Compared with normal weight, patients with obesity had significantly lower prevalence of syncope ( = 0.007) and moderate or severe mitral regurgitation ( = 0.014), and serum NT-proBNP ( = 0.004). Multiple linear regression analysis indicated that BMI ( = 0.328, < 0.001), log NT-proBNP ( = 0.308, < 0.001), presence of AF ( = 0.209, = 0.001), and left ventricular diastolic diameter index ( = 0.142, = 0.019) were independently related with LA diameter. However, BMI was not an independent predictor of the presence of AF on multivariable binary logistical regression analysis.

CONCLUSIONS

BMI was independently associated with LA diameter; however, it was not an independent predictor of prevalence of AF. These results suggest that BMI may promote incidence of AF through LA enlargement in HOCM.

摘要

背景

大量研究表明,左心房(LA)扩大是心房颤动(AF)的有力预测指标,而肥胖是心血管疾病的一个可改变的危险因素。然而,体重指数(BMI)在肥厚性梗阻性心肌病(HOCM)患者左心房大小方面的作用仍不明确。

方法

本研究共纳入423例HOCM患者(平均BMI 25.4±3.4kg/m²)。参与者根据BMI分为三组:正常体重(BMI<23kg/m²)、超重(BMI 23 - 27.5kg/m²)和肥胖(BMI≥27.5kg/m²)。

结果

与正常体重患者相比,肥胖患者晕厥(P = 0.007)、中重度二尖瓣反流(P = 0.014)及血清N末端脑钠肽前体(NT-proBNP)水平(P = 0.004)的发生率显著更低。多元线性回归分析表明,BMI(P = 0.328,P<0.001)、log NT-proBNP(P = 0.308,P<0.001)、房颤的存在(P = 0.209,P = 0.001)及左心室舒张直径指数(P = 0.142,P = 0.019)与左心房直径独立相关。然而,在多变量二元逻辑回归分析中,BMI并非房颤存在的独立预测指标。

结论

BMI与左心房直径独立相关;然而,它并非房颤发生率的独立预测指标。这些结果表明,BMI可能通过HOCM患者的左心房扩大促进房颤的发生。

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